SEEING THE INVISIBLE | A yearlong look at NC poverty

Seeing the Invisible: Desperate for dental work, an all-night wait

August 24, 2013 

  • By the numbers

    23 The percentage of North Carolinians who have no health care coverage

    47 Where North Carolina ranks in the nation in dentists per capita

    16 The percentage of N.C. dentists who accept Medicaid

  • THE SERIES

    On the last Sunday of each month this year,

    UNC Professor Gene Nichol will examine the faces and issues behind the rising poverty numbers in North Carolina. Read the other installments at newsobserver.com/ncpoverty.

At the end of July, the N.C. Dental Society’s Missions of Mercy spearheaded a massive, two-day free clinic at the Crown Expo Center in Fayetteville. More than 200 dental professionals and nearly 500 other volunteers ensured that nearly 900 grateful souls received desperately needed extractions, fillings, dentures and cleanings – procedures that would have cost half a million dollars on the market. It was a smorgasbord of generosity, accompanied by a heaping helping of gratitude. I’ve never seen anything like it.

People started lining up outside the Expo Center at 10 a.m. on Thursday in anticipation of the Friday morning opening. By 6 p.m., hundreds were lodged in the long queue – armed with water, snacks, lawn chairs and sleeping bags – prepared to spend the night to get what, for them, was otherwise unavailable treatment.

Craig and Melissa from Raleigh got the coveted first spots. He had a damaged crown that was killing him. A food server, she was convinced that her broken front teeth hurt not only her gums but also her income. They’d camped out all night at a similar clinic in Wilmington six months earlier but hadn’t been seen by closing time. They wouldn’t make that mistake again.

“I’ll wait 24 hours to stop the pain,” Craig said. “What choice do I have?”

Jackie Reeves of Zebulon was just behind them. She said her teeth had become a real problem during her pregnancy.

“There’s no way I could spend $400 on myself instead of my daughter,” she said, no matter how much her broken tooth hurt. You’ve “got to make choices.”

Further back in line, a slightly apprehensive older woman from Elizabeth City hoped to get her long-aching front teeth fixed.

“I ain’t ever done it,” she explained, “but I’ll spend the night out if it’ll stop my mouth hurting.” Asked how long it had been since she’d seen a dentist, she replied: “I guess 20 years. Who can afford a dentist?”

Randy, from Cameron, said his wife, Katie, had made him come because he needed several teeth pulled. He’d already gone to a dentist who wanted $3,500 up front. “I’m broke, so I just walked out,” he said.

When this happened a few years ago, Randy pulled a tooth with a pair of needle-nosed pliers and some Jack Daniels, Katie said, adding that she never wanted to see that again.

“You wouldn’t think that in the richest country in the world people would be standing all night in a line like this to get medical care,” she said. But, “There’s no other way. We hate to take charity, but when you see what it costs, you have to put your pride aside.”

A gentleman from Fayetteville explained that the job he’d held for two decades had been eliminated and that, three weeks earlier, the legislature had cut off his unemployment benefits.

“It’s hard to tell what life holds for me right now,” he said. “I sure can’t be spending money on my teeth, even if it means I can’t sleep.”

Sue Byrd of Operation Inasmuch arranged to take more than a dozen homeless residents to the clinic.

“They’re living and dying on the streets and under the bridges in Fayetteville,” she said. “Getting them here to get dental care is the least we can do.”

They left “with tears of joy and gratitude, just like everybody else,” she said.

The stories go on and on. Over a thousand of them. My students and I met Tar Heels ranging in age from 2 months to 77 years, camping out all night. They came from across the state – Greensboro, Durham, Garner, Sanford, Hickory, Smithfield, Jacksonville, Halifax County, Hoke County, Wilmington, Charlotte, Rocky Mount, Cumberland County and beyond. A few arrived from South Carolina and Virginia as well. Given the lengthy lines and limited resources, many had to be turned away.

As the indomitable Cathy Ory of Fayetteville’s nonprofit Care Clinic, the mission’s lead organizer, put it: “The people we serve are like us, like our neighbors; they’ve lost their jobs, or their insurance, or both; they’re hurting, with nowhere to go.”

Dr. David Dickeroff of Spring Lake, working long hours both days, spoke for many volunteers. “The problem of unmet need is a huge mountain, and we’re only able to take out a few bucketfuls this weekend,” he said. “I wish we could do it every day.”

Twenty-three percent of North Carolinians have no health care coverage – one of the highest rates in the nation. The Kaiser Family Foundation estimates that for every person without health insurance, three don’t have dental coverage. Medicaid sharply limits adult dental services, and private insurance often doesn’t cover dentistry.

Limited access to dental services plagues us as well. North Carolina ranks 47th in dentists per capita. Only 16 percent of our dentists accept Medicaid. In four counties (Currituck, Hyde, Perquimans and Tyrell), none does. Judy Klinck of Better Health, another nonprofit co-sponsor, explained: “No one familiar with health care in North Carolina could be surprised at the gigantic lines.”

Almost to emphasize the point, two days after the Fayetteville clinic, the Robeson County Health Department announced it was closing its dental facility, which had been operating 13 years. Director Bill Smith indicated the General Assembly’s refusal to expand Medicaid had sounded the death knell.

Missions of Mercy offers almost-impossible-to-describe service to low-income North Carolinians. Last year, with the help of selfless local partners, it put on 13 huge, privately funded mobile clinics across the state. But Dr. Bill Blaylock, the Missions’ director, reports it will be able to sustain only five this year.

Demand explodes. Resources, support and supply constrain.

Lynne Grates, whose Cape Fear Kiwanis began cooking breakfast for hundreds of volunteers at 4 a.m. both mornings of the clinic, summed up the force of the weekend: “I love the people in this never-ending line. But in America, in this day, in this time, no one should have to go through this.”

Gene Nichol is Boyd Tinsley distinguished professor at the UNC School of Law and director of the school’s Center on Poverty, Work and Opportunity.

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